Provider Demographics
NPI:1255781290
Name:SALAS, JULIAN
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:
Last Name:SALAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7551 JORDAN AVE UNIT 402
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-3374
Mailing Address - Country:US
Mailing Address - Phone:818-880-7523
Mailing Address - Fax:
Practice Address - Street 1:7551 JORDAN AVE UNIT 402
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-3374
Practice Address - Country:US
Practice Address - Phone:818-880-7523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator